Iatrogenic harm from restrictive interventions in mental healthcare: a human rights perspective

The use of restrictive interventions and practice by nurses in mental healthcare has the potential to cause varying levels of iatrogenic harm to patients. Restrictive interventions include physical and mechanical restraint, seclusion and enforced administration of medicines, while restrictive practice includes coercion, deprivation of liberty and reduced autonomy. The severity of physical, psychological and psychosocial harms experienced by patients subjected to these restrictions can be wide ranging. In addition, the use of these interventions and practices gives rise to ethical and moral contradictions, even when they are used legally and are clinically acceptable. This article explores the factors involved in restrictive interventions and practice such as culture, leadership, staffing levels, training, organisational policy and quality of care provision. The author also examines the implications for patients of being subjected to such interventions.